Crash carts in Intensive Care: development of a tool for situational assessment
DOI:
https://doi.org/10.30968/jhphs.2026.171.1443Abstract
Objective: To describe the process of developing and validating the content of a questionnaire aimed at evaluating the use and management of crash carts in Brazilian intensive care units (ICUs). Methods: A descriptive study with a quantitative approach was conducted to develop and validate the instrument, with stages of item construction based on theoretical references and content validation by a panel of multidisciplinary experts. The constructs addressed multidisciplinary collaboration and organizational support. Criteria of clarity, relevance, and comprehensiveness were applied, followed by the calculation of the Content Validity Index (CVI). The final version was pretested with 30 professionals working in ICUs, from January to February 2024. Results: In the first content analysis, an agreement rate of 90% was obtained for domains 1 to 4 and 100% for domain 5. Of the 37 items, 36 achieved an agreement rate of 100%, with only one item reaching 90%. In the second content analysis, all items achieved a minimum CVI of 0.8. Nevertheless, the assessment of the clarity of the title did not reach a minimum CVI of 0.8 (CVI = 0.6), and items 4 and 19 of the questionnaires received a score of “1” or “2,” requiring revision. After revisions, changing the title of the instrument, and inserting an introductory paragraph to the questionnaire, a CVI ≥ 0.80 was obtained for all items in the third content analysis. The final instrument consisted of 37 items distributed across five domains, and the pretest resulted in adjustments to the wording and response options, thereby improving the clarity and applicability of the questionnaire. Conclusion: The questionnaire demonstrated satisfactory content validity and feasibility of application to the care team in ICUs. The instrument can contribute to situational diagnoses in health process management, enabling the systematic collection of data in the context of multiprofessional practice in Intensive Care.
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References
1. Fierro Rosón J, Ruiz Bailén M, Peinado Rodríguez J, et al. Evaluación del contenido y funcionamiento de los carros de reanimación cardiopulmonar de un hospital. Med Intensiva. 2003;27(6):399-403. doi:10.1016/S0210-5691(03)79918-5
2. Silva SCD, Padilha KG. Parada cardiorrespiratória na unidade de Terapia Intensiva: considerações teóricas sobre os fatores relacionados às ocorrências iatrogênicas. Rev Esc Enferm USP. 2001;35(4):361-365. doi:10.1590/S0080-62342001000400008
3. Jacquet GA, Hamade B, Diab KA, et al. The Emergency Department Crash Cart: A systematic review and suggested contents. World J Emerg Med. 2018;9(2):93-98. doi:10.5847/wjem.j.1920-8642.2018.02.002
4. Silva VFD, Lazzari DD, Reisdorfer N, Michaelsen SC, Kuhnen AE. Analyzing the operational conditions of crash carts in clinical and surgical hospitalization units. Rev Esc Enferm USP. 2021;55:e03693. doi:10.1590/S1980-220X2019040003693
5. Camerini FG, Guarçoni TL, Henrique DM, et al. Análise da disponibilidade e adequação de medicamentos e materiais nos carros de emergência: estudo observacional. GANJ. 2021;2(4). doi:10.5935/2675-5602.20200191
6. Oliveira E, Oliveira R, Silva F, et al. Standardization of drugs in emergency trolleys in intensive care and emergency units. Rev Enf Ref. 2019;IV(22):97-106. doi:10.12707/RIV19021
7. Terwee CB, Bot SD, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42. doi:10.1016/j.jclinepi.2006.03.012
8. Pittman J, Bakas T. Measurement and instrument design. J Wound Ostomy Continence Nurs. 2010;37(6):603-607. doi:10.1097/WON.0b013e3181f90a60
9. Coluci MZO, Alexandre NMC, Milani D. Construção de instrumentos de medida na área da saúde. Ciênc saúde coletiva. 2015;20(3):925-936. doi:10.1590/1413-81232015203.04332013.
10. Günther H. Como elaborar um questionário. Série: Planejamento de pesquisa nas ciências sociais. Brasília: UnB; 2003.
11. Turner RR, Quittner AL, Parasuraman BM, et al. Patientreported outcomes: instrument development and selection issues. Value Health. 2007;10(Suppl 2):S86-S93. doi:10.1111/j.1524-4733.2007.00271.x
12. Meadows KA. So you want to do research? 5: Questionnaire design. Br J Community Nurs. 2003;8(12):562-570. doi:10.12968/bjcn.2003.8.12.11854
13. Bolarinwa OA. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J. 2015;22(4):195-201. doi:10.4103/1117-1936.173959
14. Gable G, Sedera D. Formative and Reflective Measurement and Validation Mismatch in Survey Research: An Archival Analysis of Information Systems Success Constructs 1985-2007. ICIS 2009 Proceedings. 2009;V(84):1-12.
15. Roberts N, Thatcher J. Conceptualizing and testing formative constructs: tutorial and annotated example. SIGMIS Database. 2009;40(3):9-39. doi:10.1145/1592401.1592405
16. Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35(6):382-385.
17. Rubio DM, Berg-Weger M, Tebb SS, et al. Objectifying content validity: Conducting a content validity study in social work research. Social Work Research. 2003;27(2):94-104. doi:10.1093/swr/27.2.94
18. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Ciênc saúde coletiva. 2011;16(7):3061-3068. doi:10.1590/S1413-81232011000800006
19. Wynd CA, Schmidt B, Schaefer MA. Two Quantitative Approaches for Estimating Content Validity. West J Nurs Res. 2003;25(5):508-518. doi:10.1177/0193945903252998
20. Sullivan GM, Artino AR Jr. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5(4):541-542. doi:10.4300/JGME-5-4-18
21. Lucian R, Dornelas JS. Mensuração de Atitude: Proposição de um Protocolo de Elaboração de Escalas. Rev Adm Contemp. 2015;19(spe 2):157-177. doi:10.1590/1982-7849rac20151559
22. Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-497. doi:10.1002/nur.20147
23. Tuckerman J, Kaufman J, Danchin M. How to use qualitative methods for health and health services research. J Paediatr Child Health. 2020;56(5):818-820. doi:10.1111/jpc.14849
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